| NPI | 1467869024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME156033) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME156033) |
| 207V00000X Obstetrics & Gynecology (Licence: TX BP10050292) | |
| 207V00000X Obstetrics & Gynecology (Licence: CT 57255) | |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2022-10-17 |