| NPI | 1881924157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME108552) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI md13153) |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2012-06-11 |