| NPI | 1699833616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME165953) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101056705) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2026-03-23 |