| NPI | 1780668368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI TP095592) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD040512E) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2009-11-20 |