| NPI | 1114185923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA A137492) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 260997) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 260997) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2020-11-11 |