| NPI | 1881856797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME150628) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 52771) |
| 207V00000X Obstetrics & Gynecology (Licence: OH 35.126628) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35.126628) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME150628) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME150628) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2022-08-30 |