| NPI | 1053367714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 15049) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AR R3759) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-03-30 |