| NPI | 1144219346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 172513) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 172513) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2022-03-04 |