| NPI | 1053615690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NY 259678) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: CT 82824) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 259678) | |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2026-02-18 |