| NPI | 1497782213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C52576) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 204556) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-08-20 |