| NPI | 1891138863 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 288016) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD472069) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2022-09-28 |