NPI | 1801090626 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: KY 04495) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS018028) |
207V00000X Obstetrics & Gynecology (Licence: NC 2011-00750) | |
Enumeration Date | 2007-06-14 |
Last Update Date | 2022-07-07 |