| NPI | 1508858614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 327629) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA os007838l) |
| 207V00000X Obstetrics & Gynecology (Licence: PA OS007938L) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-05-23 |