| NPI | 1881724961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME146892) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A102209) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-09-30 |