| NPI | 1073516944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS010395L) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: PA OS010395L) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-04-16 |