| NPI | 1467423632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME48532) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME48532) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2011-09-27 |