| NPI | 1902874506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA02822800) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA28228) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2021-08-19 |