NPI | 1114125051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME138763) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 232784) |
207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: GA 071350) | |
Enumeration Date | 2007-07-03 |
Last Update Date | 2019-07-10 |