| NPI | 1376958306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD465424) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301106076) |
| Enumeration Date | 2014-06-28 |
| Last Update Date | 2024-06-11 |