| 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 |