| NPI | 1083110969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: KY 61035) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CO DR.0068061) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OH 35.153748) | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2025-07-25 |