| NPI | 1750486460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME 97653) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 231571) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-03-19 |