| NPI | 1184887853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09827300) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 267669) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2016-05-18 |