| NPI | 1619911906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA04620500) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA46205) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2024-02-05 |