| NPI | 1578628350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: PA MD483702) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TN 35070) |
| 207V00000X Obstetrics & Gynecology (Licence: TN 35070) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2026-03-23 |