| NPI | 1518391275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA A125897) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A125897) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2022-02-11 |