| NPI | 1932145216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME159825) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME 018218) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 382507173) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-06-16 |