| NPI | 1760690358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: MA 244425) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: MA 244425) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2014-10-27 |