| NPI | 1083881544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 051393) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD434368) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2015-02-12 |