| NPI | 1386624773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB05825100) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS010386L) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2021-02-24 |