| NPI | 1699119172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: KY 56332) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57.023302) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2024-08-02 |