| NPI | 1083646194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA07445600) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD066771L) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-04-23 |