| NPI | 1730344417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 275040) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2017-01224) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2025-03-28 |