| NPI | 1700081585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME118314) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101233197) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2014-04-23 |