| NPI | 1174562847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA OS016235) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB07347000) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2012-08-31 |