| NPI | 1629578257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME163133) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 82361) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME163133) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2025-01-17 |