| NPI | 1316987670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q9906) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25ma07463800) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-04-27 |