| NPI | 1588892202 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: RI MD15051) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 241250) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 0051726) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2016-04-04 |