| NPI | 1396711974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD417657) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 148178) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2021-03-23 |