| NPI | 1851394530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 62771) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME DO1972) |
| 207V00000X Obstetrics & Gynecology (Licence: OR DO17052) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2022-07-21 |