| NPI | 1972512606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: PR 16233) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 229923) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PR 16233) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-06-24 |