| NPI | 1801837638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 205063) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI 7227) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 044654) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2013-10-11 |