| NPI | 1518908995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: KY 28124) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY 28124) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: KY 28124) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-05-29 |