| NPI | 1346213949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME133886) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 14096) |
| 207V00000X Obstetrics & Gynecology (Licence: TX N8187) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2023-05-04 |