| NPI | 1417375742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NV 21001) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 21001) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-06-28 |