| NPI | 1154323004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: VA 0101022700) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101022700) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2010-10-22 |