| NPI | 1164496279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA06410800) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD054273L) |
| 207V00000X Obstetrics & Gynecology (Licence: NJ MA064108) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-05-26 |