| NPI | 1023208550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 245179-1) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA 20A 10142) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2013-07-10 |