| NPI | 1184786915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO204571) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0102050130) |
| 207V00000X Obstetrics & Gynecology (Licence: ME DO1391) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2023-09-18 |