| NPI | 1295975142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 69364) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD444591) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2024-04-09 |