| NPI | 1780606160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: MA 76366) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA 76366) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-01-06 |