| NPI | 1982992095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: PA MD470602) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 38684) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2020-06-23 |