| NPI | 1639112451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OH 35056039) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: IN 01086901A) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2021-12-14 |