| NPI | 1518949270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MT 128973) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2002012320) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CT 055981) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2025-01-13 |