| NPI | 1093758567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD462923) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 21024) |
| 207V00000X Obstetrics & Gynecology (Licence: WI 70421) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2023-02-23 |