| NPI | 1124280581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA 20A11769) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2020-02-18 |