| NPI | 1205179660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: VT 042-0015492) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 62947-20) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2021-09-16 |