| NPI | 1922399351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA09881800) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 183815-1) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2022-01-26 |