| NPI | 1083773121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: PA OS005607-L) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NJ 25MB08055600) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2018-10-09 |