| NPI | 1861521460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OH 35-092322) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 24369) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA A92102) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2010-03-30 |