| NPI | 1952374225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME106787) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 10561) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2019-11-26 |