| NPI | 1043639487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: VA 0101272436) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2025-01-16 |