| NPI | 1881861433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA10761600) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 45468) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2020-02-18 |