| NPI | 1285764506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB10858900) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 208855) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-08-19 |