NPI | 1265590301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY MD094474-1) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 23812) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2007-07-08 |