| NPI | 1114048329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CT 55313) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 55313) |
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MA 269626) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-07-21 |