| NPI | 1346223286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 98053) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 46071) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2015-04-29 |