| NPI | 1750609251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME148262) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2017-02092) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 2017-02092) | |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2022-07-07 |