| NPI | 1033163365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA05459900) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 36392) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2026-05-26 |