| NPI | 1043403363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: MN 52408) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 52408) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2021-09-13 |