| NPI | 1427251529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME127287) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX M3378) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AZ 45722) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2016-05-18 |