| NPI | 1528647989 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 51129)  | 
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AL 51129)  | 
| Enumeration Date | 2021-04-05 | 
| Last Update Date | 2025-09-07 |