| NPI | 1710954375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00044139) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 3083326-1205) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: WA MD00044139) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2021-04-01 |