| NPI | 1730379934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: TX H6415) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX H6415) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2015-10-20 |