| NPI | 1003176892 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 143506)  | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: CA GFE49979)  | 
| Enumeration Date | 2012-05-25 | 
| Last Update Date | 2023-03-07 |