| NPI | 1528171261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: PR 6545) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PR 6545) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2019-05-08 |