| NPI | 1023011335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL 23773) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME23773) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2023-03-20 |