| NPI | 1508023052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME111533) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA VA 0101251392) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101251392) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-07-22 |