| NPI | 1306871462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NM 93-421) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 9601516) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: WA MD60215295) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-04-30 |