| NPI | 1861454704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME 48260) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME48260) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2019-02-25 |