| NPI | 1689695009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 181342) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD493089C) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-12-17 |