| NPI | 1497042444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: KS 04-41044) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2011019435) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2018-09-05 |