| NPI | 1235169244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: MA 154506) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 154506) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2022-09-20 |