| NPI | 1790179661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA A142749) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A142749) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-10-20 |