| NPI | 1467557389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 200430) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 200460) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2022-06-10 |