| NPI | 1003958539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AZ 67450) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 48145) |
| 207V00000X Obstetrics & Gynecology (Licence: AZ 67450) | |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: WI 48145) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-11-09 |