| NPI | 1396265971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME149878) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125.071410) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036.153742) | |
| 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA11180600) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2021-08-31 |