| NPI | 1194806323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: TN MD16784) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD0000016784) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-03-07 |