| NPI | 1093820151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 198920) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA 130498) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-01-26 |