| NPI | 1780630095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA A68842) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NJ 25MA08946800) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-01-06 |