| NPI | 1568520708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NY 1421871) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NY 142187) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-03-07 |