| NPI | 1740319003 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 51333) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MD D71583) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MO 2013044823) | |
| 207V00000X Obstetrics & Gynecology (Licence: MD D71583) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2024-06-12 |