| NPI | 1619190816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09302700) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 259463) |
| 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: NJ 25MA09302700) | |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2009-00608) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-02-27 |