| NPI | 1104263698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD464212) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10067000) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2018-06-27 |