| NPI | 1316046063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: RI 14709) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NH 11464) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 249289) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-07-24 |