| NPI | 1780977348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09621500) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT199072) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 277805) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2015-05-07 |