| NPI | 1225006190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 087054) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 012331) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2013-10-16 |