| NPI | 1821065137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD065622L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 201510) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2021-03-11 |