| NPI | 1235455684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MA 245047) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NH 19334) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 245047) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2019-05-22 |