| NPI | 1154343929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 09393R) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: LA 09393R) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2008-10-30 |