| NPI | 1619123825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD443528) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2019-06-24 |