| NPI | 1720058571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: FL ME120459) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NY 224909) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-07-20 |