| NPI | 1609239003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NJ 25MA12301300) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME145611) | 
| 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA12301300) | |
| Enumeration Date | 2016-04-01 | 
| Last Update Date | 2024-08-12 |