| NPI | 1790939528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MD D0082181) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 276786) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101263167) | |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2025-12-15 |