| NPI | 1730156415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 61329) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA60436) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2021-03-25 |