| NPI | 1811906878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ MA0788960) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD-060937-L) |
| 208000000X Pediatrics (Licence: NJ MA0788960) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2016-04-25 |