| NPI | 1750542395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME156854) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101246077) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2023-06-23 |