| NPI | 1023422375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: FL ME152950) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME152950) |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2022-04-06 |