| NPI | 1447277801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NY 247242-01) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 229633) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 247242) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2026-03-18 |