| NPI | 1154476190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: DE C1-0008694) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT186498) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-10-16 |