| NPI | 1457300550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: OR MD17368) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD17368) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA MD00044007) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OR MD17368) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2019-02-13 |