| NPI | 1043300114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: CA A38218) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-07-21 |