| NPI | 1669444352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME157559) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2010007571) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2022-11-18 |