| NPI | 1811429319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: NJ 25MA12334800) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-09-24 |