| NPI | 1942437181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TN 54488) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2013-00935) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2017-11-16 |