| NPI | 1811981756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 60319) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD049482L) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2024-01-30 |