| NPI | 1952498412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: OH 35-048940) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: KY 25058) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-08 |