| NPI | 1972513935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NJ 25MA11036900) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0204048010) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA11036900) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-06-15 |