| NPI | 1386087559 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AL 35794)  | 
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CT 64933)  | 
| Enumeration Date | 2013-04-08 | 
| Last Update Date | 2020-04-24 |