| NPI | 1023576014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA03672300) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 200903) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2021-07-23 |