| NPI | 1306866413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TX L5310) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35088120) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-03-28 |