NPI | 1538157029 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 251966) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA06380200) |
Enumeration Date | 2005-10-10 |
Last Update Date | 2010-07-29 |