| NPI | 1982892816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 202219) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME128480) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2021-07-22 |