| NPI | 1649333436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: IA MD-45798) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 24932) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 46247) | |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MT MED-PHYS-LIC-76691) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2022-05-03 |