| NPI | 1326234949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME134711) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 26495) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2025-02-18 |