| NPI | 1063649085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 269005) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125-056457) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2022-07-21 |