| NPI | 1760419998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 236163) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA 24543) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2026-07-07 |