| NPI | 1629076914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ME 7277) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME 007277) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2007-12-14 |