NPI | 1811990401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TX C8872) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX C8872) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2013-11-14 |