| NPI | 1548290885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 226901) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA03940100) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-07-24 |