| NPI | 1578592135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: GA 041008) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 041008) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-12-03 |