| NPI | 1841610920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OR MD209464) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 65266) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2022-08-01 |