| NPI | 1104106244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: CT 67246) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 280223) |
| 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 280223) | |
| Enumeration Date | 2011-08-21 |
| Last Update Date | 2021-05-06 |