| NPI | 1336152503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD022242E) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME94024) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2017-03-07 |