| NPI | 1124095278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: MI 5101009519) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2023-06-27 |