| NPI | 1942403704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NJ 25MA02355200) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NY 92279) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2009-01-02 |