| NPI | 1316982416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD053519L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 29191) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-08-06 |