| NPI | 1922184258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME119487) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO R5C65) |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2020-11-20 |