| NPI | 1922366061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: WI 81734) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 02005799A) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: KY 03938) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 03938) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2025-01-21 |