| NPI | 1174782635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: FL ME120070) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2015-03-05 |