| NPI | 1063404093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD061728L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25IA12906500) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2025-12-16 |