| NPI | 1699900191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NC 2018-02494) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: NJ 25MB09179600) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2023-10-13 |