| NPI | 1548286511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA G28911) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA G28911) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2017-03-02 |