| NPI | 1154390714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MD D0045495) |
| Additional Taxonomies | 2088F0040X Urology Female Pelvic Medicine and Reconstructive Surgery (Licence: MD D0045495) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2014-02-03 |