| NPI | 1043205230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 232914) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 217435) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2007-10-27 |