| NPI | 1851544142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 272455) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD456254) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2017-04-07 |