| NPI | 1447644935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME137582) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2020019057) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2023-06-23 |