| NPI | 1518033125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10171300) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 46694) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MD419760) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2025-10-07 |