| NPI | 1306969480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: WV 15951) |
| Additional Taxonomies | 207VH0002X Obstetrics & Gynecology, Hospice and Palliative Medicine (Licence: WV 15951) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WV 15951) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2022-07-21 |