| NPI | 1669537601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: KY 56993) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K7489) |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2020-02944) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2024-01-20 |