| NPI | 1316998271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NE 15730) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 15730) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-06-22 |