| NPI | 1255406120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 124122) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 064781) |
| 207V00000X Obstetrics & Gynecology (Licence: WI 51351-20) | |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2023-07-11 |