| NPI | 1497828644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: GA 70729) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 180238) |
| 207V00000X Obstetrics & Gynecology (Licence: IN 0167702A) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-06-23 |