| NPI | 1205416146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101289971) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 332756) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2026-08-14 |