| NPI | 1770835282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB09876400) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 281062) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2017-10-27 |