| NPI | 1720045834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: KY 37030) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 37030) |
| 2086X0206X Surgery Surgical Oncology (Licence: KY 37030) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2021-11-23 |