| NPI | 1659318392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: RI MD09135) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 156881) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2026-04-30 |