| NPI | 1699756577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD442570) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD442570) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-08-13 |