| NPI | 1013085174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX N7857) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35083921) |
| 207V00000X Obstetrics & Gynecology (Licence: TX N7857) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2019-10-30 |