NPI | 1245649359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 000000000000) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09538100) |
Enumeration Date | 2014-08-04 |
Last Update Date | 2021-09-28 |