| NPI | 1174758155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD454276) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME116269) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2015-06-18 |