| NPI | 1750524690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101262030) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME103639) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2024-04-23 |