| NPI | 1619070836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 221496) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 51389) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2025-03-17 |