| NPI | 1699780106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: PA MD065192L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD25459) |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD00048485) | |
| 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: OR MD25459) | |
| 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: WA MD00048485) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-06-05 |