| NPI | 1497033021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 57753) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 279387) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2021-02-19 |