| NPI | 1518060789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 031245) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NH 20912) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2021-09-29 |