| NPI | 1164840385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: KY 51094) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 51094) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-07-21 |