| NPI | 1376589531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MN 39269) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 39269) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2014-12-05 |