| NPI | 1871779579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NJ 25MA05656100) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA05656100) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |