| NPI | 1396107769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA13106500) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD494788) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2026-06-02 |