| NPI | 1144482340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME114951) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 003122) |
| Enumeration Date | 2008-06-28 |
| Last Update Date | 2014-01-24 |