| NPI | 1700889763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 11790) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ME MD24521) |
| 207V00000X Obstetrics & Gynecology (Licence: ME EL211024) | |
| 207V00000X Obstetrics & Gynecology (Licence: RI MD17443) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-04-29 |