| NPI | 1861407652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME139018) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA C141968) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2023-06-22 |