| NPI | 1942260781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME45769) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 45769) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2024-07-26 |