| NPI | 1871597518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME144040) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI JM068606) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2023-02-28 |