| NPI | 1578520821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NC 9900667) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 9900667) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2019-01-04 |