| NPI | 1659333615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NV 11876) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA MD60204443) |
| 208800000X Urology (Licence: WA MD60204443) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-09-17 |