| NPI | 1144277864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME122441) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 052478) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2024-04-29 |