| NPI | 1215054622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: OK 9182745555) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101016407) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2013-08-07 |