| NPI | 1750301743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 233343) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI MD7686) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-04-23 |