| NPI | 1790873891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08052400) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NJ 25MA08052400) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2016-05-03 |