NPI | 1215463807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA1153600) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI MD20065) |
Enumeration Date | 2017-05-03 |
Last Update Date | 2024-08-13 |