NPI | 1982694600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 220260) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 82145) |
Enumeration Date | 2005-10-25 |
Last Update Date | 2021-01-28 |