| NPI | 1871563452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME57973) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: FL ME0057973) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2019-03-01 |