| NPI | 1619044088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 053154) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MI 053154) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |