| NPI | 1588629570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: SD 7502) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 46562) |
| 207V00000X Obstetrics & Gynecology (Licence: OH 87551) | |
| 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: OH 87551) | |
| 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: WI 46562) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2020-11-25 |