| NPI | 1124071121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: PA MD065985L) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: PA MD065985L) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-05-03 |