| NPI | 1285607143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD425473) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 179186-1) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2011-09-16 |