| NPI | 1669477071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: WI 59856) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 038252) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2014-09-18 |