| NPI | 1487181962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME147490) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL TRN24520) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2021-06-02 |