| NPI | 1740283688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TN MD27626) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD 27626) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101051116) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-03-18 |