| NPI | 1831179894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 78322) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI MD08974) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2024-07-01 |