| NPI | 1912910191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E-10891) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0102202980) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 222973) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2018-09-07 |