| NPI | 1760467252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: AZ 23052) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: MN 35453) |
| 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: FL ME105631) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-09-03 |