| NPI | 1932168721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME65279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME65279) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME 0065279) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2024-08-21 |