| NPI | 1740447531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME132159) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 200800781) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2020-05-26 |