| NPI | 1487150439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 3359) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD478413) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-07-09 |