| NPI | 1962819276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME137033) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME137033) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN20748) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2022-09-06 |