| NPI | 1639234172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME96243) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 14826) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2022-03-31 |