| NPI | 1124336581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MI 4301511601) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD452810) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 296225) | |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301511601) | |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2024-08-22 |