| NPI | 1902001936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD444517) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57.010801) |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101245248) | |
| 207V00000X Obstetrics & Gynecology (Licence: NY 266248) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2019-04-15 |