NPI | 1174083414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MA 1015458) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125074871) |
Enumeration Date | 2019-03-22 |
Last Update Date | 2023-06-15 |