| NPI | 1730576919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA11436700) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 295891) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2022-06-30 |