| NPI | 1164614434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 236310) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME114613) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2024-04-18 |