| NPI | 1275791436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 20A 11076) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 250458) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2023-11-02 |