| NPI | 1760470959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NC 200001591) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD421884) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-11-02 |