| NPI | 1295735215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD033610E) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35044064W) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2021-10-08 |