| NPI | 1336147693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL OS11075) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL os11075) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036102614) | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2025-10-06 |