| NPI | 1275778680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: WV 26798) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 26798) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2022-04-12 |