NPI | 1639141815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD423541) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ MA079240) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2012-07-31 |