| NPI | 1205139284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NY 261795) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2017-01-10 |