| NPI | 1790721199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0062114) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 199243) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-04-10 |