NPI | 1093158081 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 305582-01) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2017-01861) |
Enumeration Date | 2013-04-09 |
Last Update Date | 2020-08-16 |