| NPI | 1164681987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX P0145) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX P0145) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2025-06-04 |