NPI | 1902079858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.138747) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 252434) |
207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08842100) | |
Enumeration Date | 2008-04-10 |
Last Update Date | 2021-10-14 |