| NPI | 1497736847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 215898) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 213684) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2021-12-02 |