| NPI | 1174518401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME102182) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME102182) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2016-10-14 |