| NPI | 1225158132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MN 51460) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 51460) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2015-01-15 |