| NPI | 1366603664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD445979) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT192579) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2014-11-18 |