| NPI | 1457440976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL MFC 1675) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 082516) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2011-11-10 |