| NPI | 1346312717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD08002) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: RI MD08802) |
| 2086X0206X Surgery, Surgical Oncology (Licence: RI MD08802) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2019-12-30 |