| NPI | 1699701623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD071109L) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2017-01-25 |