| NPI | 1447439245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: FL ME 40974) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 0040974) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2022-11-22 |