| NPI | 1407834211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD40762) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME91543) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101241983) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TN MD40762) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2019-07-30 |