| NPI | 1730632886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME163795) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A165967) |
| 207VG0400X Obstetrics & Gynecology Gynecology (Licence: FL ME163795) | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-03-28 |