| NPI | 1811952161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD067848L) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: PA MD067848L) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |