| NPI | 1992809982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 026837) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 5523899) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2011-10-27 |