| NPI | 1669575163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: WA MD60330578) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX H8332) |
| 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: TX H8332) | |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD60330578) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2013-10-24 |