| NPI | 1841217486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 032194) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 182994) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-11-02 |