| NPI | 1285626721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ 25MA03477400) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA03477400) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2008-11-03 |