| NPI | 1053376764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35095240) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD419562) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2022-01-05 |