| NPI | 1366513749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 239154) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08559900) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2016-03-09 |