NPI | 1598767725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME130426) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY 13196A) |
Enumeration Date | 2005-06-01 |
Last Update Date | 2021-04-12 |