| NPI | 1942230040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: VA 0101230231) |
| Additional Taxonomies | 2088F0040X Urology Female Pelvic Medicine and Reconstructive Surgery (Licence: VA 0101230231) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-02-21 |