| NPI | 1962443309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA md-034247-L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD-034247-L) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-08 |