| NPI | 1063419059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VH0002X Obstetrics & Gynecology, Hospice and Palliative Medicine (Licence: PA MD039997E) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: PA 039997E) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2020-10-12 |