| NPI | 1366458804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD429710) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 276134) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-09-07 |