| NPI | 1972999266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AZ 67910) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 59600) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TN 59600) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2023-07-05 |