| NPI | 1699734863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NC 200000648) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2000-00648) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2022-01-04 |