NPI | 1912535949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME167942) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 261085) |
Enumeration Date | 2020-03-27 |
Last Update Date | 2024-09-03 |