| NPI | 1750609699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: PA MD008096E) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NJ 25MA01994900) |
| Enumeration Date | 2010-05-15 |
| Last Update Date | 2010-05-15 |