| NPI | 1639260045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 150208) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 150208-1) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-11-22 |