| NPI | 1386626760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25Mao3411200) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: PA MD019488E) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |