| NPI | 1124035688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 152227) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD070063L) |
| 207V00000X Obstetrics & Gynecology (Licence: MD D0081156) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-08-09 |