| NPI | 1811101231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD446841) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME106885) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-05-13 |