| NPI | 1386228310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD485463) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT222701) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2025-09-02 |