| NPI | 1619942810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: NY 223700) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 223700) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2023-08-10 |