| NPI | 1942529367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: NY 265211) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology Female Pelvic Medicine and Reconstructive Surgery (Licence: NJ 25MA08762100) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2015-08-09 |