| NPI | 1457311821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 252535) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME 015364) |
| 207V00000X Obstetrics & Gynecology (Licence: NH 10965) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2017-03-30 |