| NPI | 1861728164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 255219) |
| Additional Taxonomies | 282NW0100X General Acute Care Hospital, Women (Licence: NY 255219) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2020-06-09 |