NPI | 1407122930 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MA 26265862) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 26265862) |
207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NH 22231) | |
Enumeration Date | 2012-03-29 |
Last Update Date | 2022-10-31 |