| NPI | 1700816311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MN 40682) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 40682) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-12-11 |