| NPI | 1790809010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 35.097276) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-08-27 |