| NPI | 1043421860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 50091) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2010015154) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 50091) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MN 108036) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-19 |