| NPI | 1487664595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MI 4301059565) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: IA 31409) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2023-03-07 |