| NPI | 1831167162 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: CA G149086)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA G149086)  | 
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA06718800)  | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 209108)  | |
| Enumeration Date | 2006-03-11 | 
| Last Update Date | 2025-08-11 |