| NPI | 1619907516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: PA MD445790) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MO 2005002439) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2012-07-26 |