| NPI | 1821108200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 45249) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 043048) |
| 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: KY 45249) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-08-06 |