| NPI | 1669821245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DE C1-0027504) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD480916) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 1023988) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2026-04-30 |