| NPI | 1881985414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CT 054973) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08976200) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 261017) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA A111708) | |
| Enumeration Date | 2011-04-30 |
| Last Update Date | 2019-10-10 |