| NPI | 1265489215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD042352E) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ MA49210) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2022-08-04 |