| NPI | 1104244888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: VT 042.0014060) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 308826) |
| 207V00000X Obstetrics & Gynecology (Licence: VT 042.0014060) | |
| 207V00000X Obstetrics & Gynecology (Licence: NY 308826) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2026-09-29 |