| NPI | 1780617373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM MD2004-0673) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 138912) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2016-02-05 |