| NPI | 1417129792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 262587) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD443654) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2013-09-20 |