| NPI | 1780172601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME154681) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX 681691) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2023-06-23 |