| NPI | 1447255088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: NY 146151) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: NY 146151) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2010-09-21 |