| NPI | 1376776138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 254653) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08662500) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2010-08-04 |