| NPI | 1770570301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101242000) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: ME MD18831) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2021-01-28 |