| NPI | 1225365075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME149530) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.135060) |
| 208M00000X Hospitalist (Licence: FL ME149530) | |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301064871) | |
| Enumeration Date | 2009-11-14 |
| Last Update Date | 2022-03-31 |