| NPI | 1760690440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101254638) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: VA 0101254638) |
| 207V00000X Obstetrics & Gynecology (Licence: AL 26477) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2026-04-23 |