NPI | 1831167162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G149086) |
Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA G149086) |
207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA06718800) | |
207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 209108) | |
Enumeration Date | 2006-03-11 |
Last Update Date | 2020-10-15 |