| NPI | 1144219130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09167800) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 051454) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2012-10-18 |