| NPI | 1801863659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NY 163782) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NY 163782-1) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2018-09-04 |