| NPI | 1548227416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TN 21128) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD21128) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-05-17 |