| NPI | 1669668737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL os8387) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL os8387) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL OS8387) | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2016-11-16 |