| NPI | 1225323678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME123249) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT200411) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2018-03-07 |