| NPI | 1720008741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 236470) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX P5476) |
| 207V00000X Obstetrics & Gynecology (Licence: RI MD10395) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-10-03 |