| NPI | 1699772624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 205044) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 205044) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2008-07-23 |