| NPI | 1265745053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME121953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096267) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036.143468) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2022-10-06 |