| NPI | 1932173341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 161388) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 161388) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 161388) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-03-13 |