| NPI | 1316981541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MN 44507) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 44507) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2015-09-15 |