| NPI | 1801242342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 304059) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MD P32552) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2020-07-07 |