| NPI | 1205812849 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD034135L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10339000) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2022-10-20 |