| NPI | 1528014412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA06484300) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MAO64843) |
| 207V00000X Obstetrics & Gynecology (Licence: CA G166702) | |
| 207V00000X Obstetrics & Gynecology (Licence: GA 84663) | |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME148158) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-05-07 |