| 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: NC 2011-00750) |
| 207V00000X Obstetrics & Gynecology (Licence: PA OS018028) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2025-09-15 |