| NPI | 1841462520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 028169) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME83189) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |