| NPI | 1265401889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 179339) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 53657) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2019-02-01 |