NPI | 1316053101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 128735) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35-066308) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2022-07-21 |