| NPI | 1255645594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AL 35742) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 164456) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2018-10-09 |