| NPI | 1790982031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MI 4301089753) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301089753) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2026-07-01 |