| NPI | 1518932052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME105369) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NH 7662) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2012-02-01 |