NPI | 1861490542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA 12939r) |
Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: LA 12939r) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2017-06-19 |