| NPI | 1669492641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME0061235) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0061235) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME61235) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-08-16 |