NPI | 1376625681 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 97208) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL ME97208) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2008-09-19 |