| NPI | 1174500128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: GA 207VX0201X) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 049173) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2015-08-14 |