| NPI | 1447491337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD446479) |
| Additional Taxonomies | 193400000X Single Specialty (Licence: PA MD446479) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101278397) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2023-12-01 |