| NPI | 1376593921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101280775) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 239894) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-11-28 |