NPI | 1548275902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 252781) |
Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME 89380) |
207Q00000X Family Medicine (Licence: NY 252781) | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2021-02-23 |