| NPI | 1407352768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10315100) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 298304) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2019-12-09 |