| NPI | 1346234200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD464670) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 20927) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-08-30 |