| NPI | 1942211503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: MO 110908) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MO 110908) |
| 207V00000X Obstetrics & Gynecology (Licence: MO 110908) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-01-15 |