| NPI | 1306956610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 12470) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 2114641) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-09-09 |