| NPI | 1386610178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME130623) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA G141830) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2025-09-03 |