| NPI | 1881692002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: CA A30257) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A30257) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A30257) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2021-10-05 |