| NPI | 1124255922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OK 29683) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 125-056283) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2018-09-19 |