| NPI | 1205819000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 222193) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI MD09412) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2025-03-05 |