| NPI | 1164410643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NJ 25MA08681200) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME91461) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ME91461) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA08681200) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2019-01-05 |