| NPI | 1205957404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: AL MD.35078) | 
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AL MD.35078) | 
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2016-07-07 |