| NPI | 1841234580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD440249) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2016-06-13 |