| NPI | 1871567610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB11162200) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX M7441) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 212757) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2024-05-09 |