| NPI | 1740643741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: MA 1015242) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD471009) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-08-03 |