| NPI | 1851399349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME0039583) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 592463341) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-03-21 |