| NPI | 1790910651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C194828) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME1150657) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2025-03-26 |