| NPI | 1740695204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME132964) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL 132964) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-07-21 |