| NPI | 1154526028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME116367) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD432168) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-10-22 |