| NPI | 1710925078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| 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 |