| NPI | 1144296393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 279598) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD424318) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2015-06-18 |