| NPI | 1417196601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2024-01736) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 234997) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2025-04-23 |