| NPI | 1558597757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME122020) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 266374) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2015-12-30 |