| NPI | 1780679969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CT 046991) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME0080439) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2015-11-25 |