| NPI | 1427012780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD040750E) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD040750E) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-09-05 |