| NPI | 1366413916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD425710) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 147836-1) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2011-09-15 |