| NPI | 1609226950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-15245) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT210943) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-12-18 |