| NPI | 1578533774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 88898) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD052801L) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2024-08-02 |