| NPI | 1326337502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME148088) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 279493) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2023-01-27 |