| NPI | 1306885512 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME120130) | 
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 214883) | 
| 207V00000X Obstetrics & Gynecology (Licence: FL ME120130) | |
| Enumeration Date | 2006-06-05 | 
| Last Update Date | 2020-06-08 |