| NPI | 1770570475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: FL ME69232) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME69232) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2023-04-25 |