| NPI | 1205949476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 232515) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 232515) |
| 207Q00000X Family Medicine (Licence: NY 232515) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-08-15 |