| NPI | 1669560926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME104419) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL r9293) |
| 207V00000X Obstetrics & Gynecology (Licence: KS 04-51393) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-08-19 |