| NPI | 1346697042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: VA 0102205104) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2023-02608) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2025-06-02 |