| NPI | 1710482971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 339023) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125.072073) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 82691) | |
| 207V00000X Obstetrics & Gynecology (Licence: AZ 69461) | |
| 207V00000X Obstetrics & Gynecology (Licence: UT 12851252-1205) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-08-29 |