| NPI | 1235347477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA C169111) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AL 29582) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NC 2012-01379) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-09-02 |