| NPI | 1316939101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: AZ 26784) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AZ 26784) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2014-02-14 |