| NPI | 1396815023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 175485) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 6934299-8017) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2019-02-14 |