| NPI | 1912232372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD063129L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 98-00408) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 039328) | |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD00036917) | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |