| NPI | 1023000544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OH 35032949) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 24791) |
| 174400000X Specialist (Licence: KY 24791) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-08-08 |