| NPI | 1518033125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD419760) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 46694) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2019-05-06 |