| NPI | 1740352806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME100299) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 001788) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-05-17 |