| NPI | 1205815636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MN 34770) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 34770) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MN 34770) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2020-08-12 |