| NPI | 1134354954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MI 4301109498) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NY 269250) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2016-06-10 |