| NPI | 1699001073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD190815) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT190779) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2023-04-21 |