| NPI | 1235164476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX s6330) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MI 4301059625) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301059625) | |
| 207V00000X Obstetrics & Gynecology (Licence: OH 35-075267) | |
| 207V00000X Obstetrics & Gynecology (Licence: TX s6330) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35-075267) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-07-17 |