| NPI | 1154326197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 167742) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 167742-1) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2016-11-16 |