| NPI | 1972569523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101263220) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 219513) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2023-12-20 |