| NPI | 1487737698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35069254) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-09-02 |