| NPI | 1790177574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD481182) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 314829) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2023-06-28 |