| NPI | 1760443394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NY 201576) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 054294) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-12-08 |