| NPI | 1023086048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 325875) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD053952L) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2024-04-18 |