| NPI | 1609801430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD 42819) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD426565) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2025-07-10 |