| NPI | 1861587305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00018942) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME 12538) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-11-19 |