| NPI | 1215370879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NJ 25MA11194900) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 1215370879) |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2024-10-29 |