| NPI | 1306821590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME133507) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 32133) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MN 32133) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2018-10-17 |