| NPI | 1356395883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD454091) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ MA77857) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2022-12-28 |