| NPI | 1205818234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX M4059) |
| Additional Taxonomies | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery (Licence: TX M0459) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2021-10-29 |