| NPI | 1366442121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD034485L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA md034485l) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2007-09-27 |