| NPI | 1578598314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB06706900) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 215848) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-02-23 |