| NPI | 1487231965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX 47244) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX 47244) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX 47244) | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |