| NPI | 1780744276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 140483) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 052672) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2014-05-22 |