| NPI | 1730143801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TN 42678) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: NC 2007-01507) |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2007-01507) | |
| 207V00000X Obstetrics & Gynecology (Licence: TN 42678) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2013-02-21 |