| NPI | 1629236062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 050078) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME84352) |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2008-05-31 |