| NPI | 1912915786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PA MD064975L) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2021-04-06 |