| NPI | 1528116514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: HI 11789) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: HI 11789) |
| 207V00000X Obstetrics & Gynecology (Licence: CA A73545) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-12-11 |