| NPI | 1528257888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: LA 332911) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 45068) |
| 207V00000X Obstetrics & Gynecology (Licence: MO 2015016230) | |
| 207V00000X Obstetrics & Gynecology (Licence: KS 04-37038) | |
| 207V00000X Obstetrics & Gynecology (Licence: LA 332911) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MO 2015016230) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: KS 04-37038) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2023-01-17 |