| NPI | 1508911538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA A92783) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A92783) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A92783) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2024-04-26 |