| NPI | 1114120490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME109151) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT190940) |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD60562825) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2023-09-27 |