| NPI | 1376586271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: TX F9340) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TX F9340) |
| 207V00000X Obstetrics & Gynecology (Licence: TX F9340) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-01-29 |