| NPI | 1639160088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 330169) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L6357) |
| 207V00000X Obstetrics & Gynecology (Licence: DE C1-0024788) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2024-11-06 |