| NPI | 1154393411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TX V8168) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MO 2020022079) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2026-01-13 |