| NPI | 1356558050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD425428) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: VA 0101242381) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101242381) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-25 |