| NPI | 1669530481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NY 313314) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 218456) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2022-09-16 |