| NPI | 1538103056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: KY 33954) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY 33954) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: KY 33954) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-12-11 |