| NPI | 1720066467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 174162-1) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 028686) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NY 174162) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CT 028686) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2016-02-04 |