| NPI | 1902992274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: CT 040237) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CT 040237) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-11-26 |