| NPI | 1700020138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: OH 35-099119) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2021-01-18 |