| NPI | 1780095133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD472008) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX 21201758) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2021-08-20 |