| NPI | 1417159229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 1016532) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI MD15449) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2024-11-01 |