| NPI | 1205367109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB11148700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 00000000000000000000) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2021-08-30 |