| NPI | 1578586798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: AL 24699) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AL 24689) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-06-10 |