| NPI | 1972660959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101260490) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 16805) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME118697) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2018-08-30 |