| NPI | 1588080147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA md012034e) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-06 |