| NPI | 1811254154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MA 265570) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NY 298186) |
| 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NH 22868) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-08-09 |