| NPI | 1538267976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: NY 142193) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 142193) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-12-03 |