| NPI | 1720071475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME53597) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME0053597) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2022-11-04 |