| NPI | 1962465278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 208297) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 208297) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2013-02-21 |