| NPI | 1023273687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OH 34.010162) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 248054) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MI 5101022136) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2021-04-22 |