| NPI | 1124381108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME163368) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN17348) |
| 207V00000X Obstetrics & Gynecology (Licence: MD D0082556) | |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2023-07-26 |