| NPI | 1386141943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD478043) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 58951) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-04-12 |