| NPI | 1104859164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA a66385) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A66385) |
| 208800000X Urology (Licence: CA A66385) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2023-03-07 |