| NPI | 1114125051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: FL ME138763) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 232784) |
| 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: GA 071350) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2019-07-10 |