| NPI | 1306286158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: AZ 54033) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301103735) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-03-15 |