| NPI | 1285624031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: SC 40796) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 9601608) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-01-04 |