| NPI | 1497763874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA04069600) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NJ 25MA04069600) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-01-22 |