| NPI | 1790733426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME147286) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: PR 8463) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-09-23 |