| NPI | 1497834964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA 20A7341) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA 20A7341) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2024-03-18 |