| 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 |