| NPI | 1629173794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME96183) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 152637) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-06-10 |