| NPI | 1538459656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 278733) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME138154) |
| 207V00000X Obstetrics & Gynecology (Licence: TN 53330) | |
| 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09098600) | |
| 207V00000X Obstetrics & Gynecology (Licence: FL 12915) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2020-07-13 |