| NPI | 1457311813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 20A5446) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 203831) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2011-06-27 |