| NPI | 1255572194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD438771) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT187989) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2017-03-21 |