| NPI | 1538423967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME163514) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ZZ 23780) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35.136534) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35.136534) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-09-04 |