| NPI | 1487879987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NM MD2013-0172) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-03-29 |