| NPI | 1902068968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD D0074489) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 60-269600) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2014-10-22 |