| NPI | 1376004085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 342004) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116037534) |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NY 342004) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-05-10 |