| NPI | 1265572093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: PA os014115) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS014115) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0102201618) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2021-05-14 |