| NPI | 1023202769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 309706) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA 4267) |
| 207V00000X Obstetrics & Gynecology (Licence: NJ MB08459100) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2021-06-24 |