| NPI | 1619928116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 37106) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA05540000) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-11-20 |