| NPI | 1902066145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: DC MD037224) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD 429803) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2019-12-06 |