| NPI | 1962477174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD435149) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ MA08428100) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 222228) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-06-11 |