NPI | 1700077021 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 102221) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 26185) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2012-12-19 |