| NPI | 1164521035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: CA A109681) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME96973) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-07-21 |