NPI | 1710925078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NJ 25MA07428500) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NY 192807-1) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2013-01-18 |