| NPI | 1558341024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: VA 0101239563) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101239563) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-03-07 |