| NPI | 1972545408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN MD0000039912) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME164268) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2024-04-04 |