| NPI | 1710914031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD475060) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00044633) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2024-08-05 |