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 |