NPI | 1346372802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 302134) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME 100218) |
Enumeration Date | 2007-03-11 |
Last Update Date | 2022-08-18 |