| NPI | 1487310314 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 26NJ01229700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 26NJ01229700) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2022-08-21 |