| NPI | 1619953932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 205606-1) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 038671) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2013-10-16 |