| NPI | 1689937518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 296495) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10904800) |
| 207V00000X Obstetrics & Gynecology (Licence: CO DR.0065182) | |
| 207V00000X Obstetrics & Gynecology (Licence: KY 53893) | |
| 207V00000X Obstetrics & Gynecology (Licence: OH 35.139324) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-12-02 |