| NPI | 1740476563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB09689400) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 050100) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 263823) | |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2024-05-30 |