| NPI | 1588983266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: IA R-8861) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NE 29590) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2022-07-21 |