| NPI | 1255304838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PA MD039279L) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 154877-1) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2011-09-16 |