| NPI | 1003852716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM MD2007-0662) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ MA68626) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2024-11-14 |