| NPI | 1316430010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: ME MD29474) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME MD29474) |
| 207V00000X Obstetrics & Gynecology (Licence: MO 2018017675) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2025-06-09 |