| NPI | 1538368873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 75523) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 246927) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2024-02-28 |