| NPI | 1831320605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08724700) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 253835) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2013-04-23 |