| NPI | 1215091905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: MA 74392) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 74392) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2013-11-21 |