| NPI | 1861422461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME0037467) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0037467) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-02-01 |