| NPI | 1356797740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX S0996) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX S0996) |
| 207V00000X Obstetrics & Gynecology (Licence: AL DO.2123) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AL 2123) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2024-09-10 |