| 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 |