| NPI | 1225045784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 70457) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 62006) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 285610) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-03-07 |