| NPI | 1538182571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD423582) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 15442R) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2016-03-02 |