| NPI | 1184070823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME142462) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL 22623) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2022-01-04 |