| NPI | 1528137650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: OH 941083) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 350704310) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX J6198O) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: LA 021118) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-04-16 |