| NPI | 1427376821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD458214) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY R2482) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301104360) | |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2016-08-31 |