| NPI | 1356876486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CO DR.0074537) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-00894) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2025-03-05 |