| NPI | 1487621132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME038761) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME38761) |
| 208D00000X General Practice (Licence: FL ME38761) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2024-05-08 |