| NPI | 1700055175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD435214) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301086415) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2020-08-05 |