NPI | 1609183474 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NJ 25MB09759400) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OT011977) |
207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: PA OS016620) | |
Enumeration Date | 2010-09-01 |
Last Update Date | 2022-12-05 |