| NPI | 1548286164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 62235) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 4865-320) |
| 207V00000X Obstetrics & Gynecology (Licence: WA MD70021880) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2025-08-07 |