| NPI | 1619935384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: FL ME94509) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME94509) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME94509) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2012-12-21 |