| NPI | 1609824481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 19529) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 217723) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX t2323) | |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NV 19529) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA A79656) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2025-07-02 |