| NPI | 1437578655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PA MD470445) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD046048) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2025-05-16 |