| NPI | 1093374225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MA 3013487) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI LP04687) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-03-13 |