| NPI | 1528047800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 675572) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 112364) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2008-05-13 |