| NPI | 1841225133 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: DC MD039970)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A86941)  | 
| 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MD D88462)  | |
| Enumeration Date | 2006-07-12 | 
| Last Update Date | 2020-10-06 |