| NPI | 1124119706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 190269) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 190269-1) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2025-08-15 |