| NPI | 1902895030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA CA146076) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME90841) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2023-03-08 |