| NPI | 1578621611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35084293) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2021-06-29 |