| NPI | 1639306202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME141400) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 76538) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2024-10-24 |