| NPI | 1851446272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME153281) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA07545700) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-08-23 |