| NPI | 1184872756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 323480) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME102902) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2023-10-04 |