NPI | 1902085103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 4281R) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME 97942) |
Enumeration Date | 2007-10-24 |
Last Update Date | 2022-06-17 |