| NPI | 1568692424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 267420) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 047622) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2015-08-09 |