| NPI | 1083970065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 307366) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD unknown) |
| 207V00000X Obstetrics & Gynecology (Licence: NH 17563) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-09-26 |