| NPI | 1780758151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD036607L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 3447081208) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2021-02-22 |