| NPI | 1538376603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA OS014705) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 2062) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-05-07 |