| NPI | 1295711042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ME MD26107) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 74029) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-11-02 |