| NPI | 1801862040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME105113) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 8518) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2018-03-17 |