| NPI | 1891997979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: WV 23474) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: WV 23474) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2018-12-14 |