| NPI | 1932595733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 281799) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 334027) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2025-03-07 |