| NPI | 1063516706 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA OS014999) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 000462) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2024-09-12 |