| NPI | 1790191542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MN 68991) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NJ 25MA10284000) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2021-08-09 |