| NPI | 1891175436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NJ 25MA10545100) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10052645) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2019-06-13 |