| NPI | 1720066558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: NJ 25MA06048700) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: PA 058743L) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2019-06-20 |