| NPI | 1508959628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 140352-1) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NJ 25MA08029900) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-04-09 |