| NPI | 1992949390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25ma08897800) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101245636) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2019-11-18 |