| NPI | 1730251737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 111399) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA03703500) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |