| NPI | 1689665846 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX R3692) | 
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX R3692) | 
| Enumeration Date | 2005-11-04 | 
| Last Update Date | 2022-07-21 |