| NPI | 1063075232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME162461) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 10778) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2023-09-27 |