| NPI | 1356324677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 212520) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 212520) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2011-01-28 |