| NPI | 1831178706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME95524) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 043459) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME95524) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2022-12-30 |