| NPI | 1831167162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G149086) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: CA G149086) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA06718800) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 209108) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2020-10-15 |