NPI | 1578978169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NY 292611) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI LP03087) |
Enumeration Date | 2014-06-23 |
Last Update Date | 2021-09-10 |