| NPI | 1043221047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MO R3N53) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MO R3N53) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2010-03-12 |