| NPI | 1851625982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 46116) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 260666) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2024-01-10 |