| NPI | 1609936293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MO 106994) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: KS 04-34426) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO 106994) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-05-04 |