| NPI | 1629042460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME67876) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 67876) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2023-03-30 |