| NPI | 1225244379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60074660) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT186614) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-05-10 |