| NPI | 1053332296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MI 4301075802) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2019-02-25 |