| NPI | 1679502454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TN 11396) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AR E1662) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2018-01-17 |