| NPI | 1669452983 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME50821)  | 
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME50821)  | 
| 208800000X Urology (Licence: FL ME50821)  | |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME50821)  | |
| Enumeration Date | 2006-01-20 | 
| Last Update Date | 2021-11-04 |