| NPI | 1225150907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB11785700) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 221354) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-10-03 |