| NPI | 1194177311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME143650) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 32316) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2025-12-09 |