| NPI | 1790937068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM md2013-0460) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME152170) |
| 207V00000X Obstetrics & Gynecology (Licence: VT 042.0012038) | |
| 207V00000X Obstetrics & Gynecology (Licence: PA mt189844) | |
| Enumeration Date | 2008-10-18 |
| Last Update Date | 2022-10-06 |