| NPI | 1215993183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 161640) |
| Additional Taxonomies | 174400000X Specialist (Licence: NE 1616401) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2015-12-29 |