| NPI | 1306392840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 305074) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB11226100) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2024-07-25 |