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 |