| NPI | 1235111493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 79483) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 208875) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2007-07-08 |