| NPI | 1508229212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD470305) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: PA MD470305) |
| 208D00000X General Practice (Licence: PA MD470305) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-06-10 |