| NPI | 1114000775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME140518) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 9900214) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-04-08 |