| NPI | 1437162161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 2081451) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 208145-1) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2019-03-13 |