| NPI | 1073673448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX L1624) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX l1624) |
| 208D00000X General Practice (Licence: TX L1624) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2013-11-01 |