| NPI | 1518043819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD070891L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 217255) |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2023-12-29 |