| NPI | 1669602553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 254340) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 66608) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MT194463) | |
| 207V00000X Obstetrics & Gynecology (Licence: NH 20139) | |
| Enumeration Date | 2009-07-26 |
| Last Update Date | 2022-12-15 |