| NPI | 1124364575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME165791) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD043537) |
| 207V00000X Obstetrics & Gynecology (Licence: MD md043537) | |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2024-01-31 |