| NPI | 1386804334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME106194) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL ME106194) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2019-01-15 |