NPI | 1033197504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME125455) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35065372) |
208800000X Urology (Licence: OH 35-065372) | |
Enumeration Date | 2006-01-05 |
Last Update Date | 2022-06-20 |