| NPI | 1689787632 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD423370) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 157207) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2015-10-21 |