| NPI | 1962755249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NC 2021-00851) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-00851) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2023-09-06 |