NPI | 1134279052 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD069744L) |
Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NV 11772) |
207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NJ 25MA08738400) | |
Enumeration Date | 2007-01-11 |
Last Update Date | 2020-12-12 |