| NPI | 1477807691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV DO2683) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 267500) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2022-09-13 |