| NPI | 1588625909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME118938) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101057909) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101057909) | |
| 207V00000X Obstetrics & Gynecology (Licence: TN 51110) | |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2014-00156) | |
| 207V00000X Obstetrics & Gynecology (Licence: SC MD36587) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2016-01-27 |