| NPI | 1275709479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 277516) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 243462) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2018-06-29 |