| NPI | 1407821838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MD DOO67330) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ MA21635) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2011-11-16 |