| NPI | 1205002946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 038600) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 038600) |
| 207P00000X Emergency Medicine (Licence: GA 038600) | |
| 207V00000X Obstetrics & Gynecology (Licence: GA 038600) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: GA 038600) | |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2012-04-10 |