| NPI | 1982719514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME45747) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 36355) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-06-23 |