| NPI | 1477521789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C54454) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME91021) |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2021-06-18 |