| NPI | 1134202286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NJ 25MA04246100) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA04246100) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-02-21 |