NPI | 1508159641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME119486) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 45070) |
Enumeration Date | 2011-05-23 |
Last Update Date | 2022-05-10 |