| NPI | 1649342411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD035437E) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD035439E) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2022-01-14 |