| NPI | 1750769568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AL 35450) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2019006464) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2024-02-01 |